News 12/20/12

From Charlie Watts: “Re: surveys. It’s interesting that you are concerned with Universal Survey’s funding source, but not KLAS’s. Vendors fund a significant part of KLAS’s operations and larger vendors with many products pay the lion’s share of KLAS’s revenues from vendors versus the smaller companies. Of even greater concern is that KLAS has assumed the responsibility of defining an EHR—with total disregard for the government’s definition of an EHR. KLAS’s list of rated vendors contains only the largest vendors. Smaller vendors, regardless of quality, are relegated to the footnote section of the rankings. KLAS footnotes several products as ‘component’ even though they are certified as a complete EHR and have successful attesters. If KLAS accurately categorized these EHRs, the rankings would be different, which would have certainly upset some of their big revenue sources. One would be led to believe that KLAS is not an independent research company and is influenced by the name brand vendors that represent the lion’s share of their income they derive from vendors.” I support transparency and I think most of these vendor-ranking surveys could benefit from better disclosure of funding sources and survey methods. Mr. H offered some great commentary on the subject a couple of years ago and came to this conclusion:

The evils of KLAS are really a reflection of the evils of its provider and vendor members. Vendors try to game the system without getting caught, while providers unwisely overweight the value of KLAS in making their IT decisions. All of that is highly profitable to KLAS, but more power to them for creating a niche that still has minimal competition and strong business after all these years.

Meadowlands Hospital Medical Center (NJ) chooses eClinicalWorks Care Coordination Medical Record and EHR solutions to advance its ACO objectives. eClinicalWorks also announces that Urban Health Plan (NY) will add eCW’s Care Coordination Medical Record for its ACO-related initiatives.

Sixty-eight percent of surgeons are employed by a hospital or large group practice instead of working in their own practices. Between 2006 and 2011, the number of full-time hospital-employed surgeons jumped 32 percent.

CareCloud appoints John J. Walsh (Constant Contact, Inc.) chief technology officer.

Medinova Physicians (NY) implements the PatientPoint Care Coordination platform to address core principals of the PCMH model for NCQA certification.

Trustees of St. John’s Medical Center (WY) decide to spend $240,000 to buy eClinicalWorks as a replacement for McKesson Practice Partner, which it has been running for five years. They say Practice Partner is not user friendly and makes it difficult to document office visits.

If you are a provider or work in the ambulatory care setting and interested in participating in our HIStalk Practice Advisory Panel once a month or so, drop me a note. We will be sending out a new survey in the next few days and welcome a broad range of insights and opinions.

The end of the year always tends to be a slow period for news, so we will likely forego a post on the 25th. Of course the real reason I’m taking the day off is that I need time for last-minute shopping, feverish gift wrapping,  and prepping for a feast or two. Best wishes to all!

E-mail Inga.

News 12/18/12

Epic wins big in the Physician Practice Solutions categories in the 2012 Best in KLAS Awards, taking the top spot in the “Over 75 physicians” categories for both EMR and PM and for the “11-75 physicians” EMR category. AthenaClinicals was the leader in the 1-10 physician EMR segment and for PM in both the 11-75 and 1-10 physicians segments. Other observations: a) Allscripts, McKesson, Vitera, and GE populated the bottom spots on the EMR rankings; b) Greenway and eClinicalworks had solid EMR rankings; c) NextGen, GE, Greenway, and e-MDs scored well in the PM segments; and d) Vitera, Allscripts, eClinicalWorks, and McKesson had the lowest spots in the PM categories.

A reader forwarded me another user satisfaction survey produced by University Survey. The report looked at ambulatory EMRs and included responses from 1,051 specialists (ophthalmologists, dermatologists, and cardiologists). The top-rated products were SRS and eClinicalWorks, while Allscripts and Greenway were ranked last. Specialists have different EMR requirements and their product preferences aren’t necessarily the same as primary care providers, but I am a little suspect of the quality of data, primarily because (a) University Survey would not respond to my direct question about whether or not a vendor or some other entity paid for the survey to be conducted, and (b) the report offers no details on the survey methodology. My opinion: KLAS, University Survey, Black Book, and similar surveys provide interesting data points, but should never be the sole consideration when making a buying decision.

The world seems like a troubling place at the moment, making it a perfect time to add a bit of levity to your day. Take a minute to read Joel Diamond’s Year in Review post, which provides a tongue-in-cheek look at the most compelling HIT news events for 2012.

American Family Care, which has 34 locations across Alabama, Tennessee, and Georgia, completes its implementation of DocuTAP’s EMR and PM products.

The 370-physician Kelsey-Seybold Clinic (TX) becomes the first healthcare organization to earn NCQA accreditation as an ACO.

Vitera Healthcare announces the general release of Live Chat, which provides customers with immediate online access to Vitera customer support.

Assuming you are reading this post on a desktop or laptop and not a mobile device, you have likely noticed our brand new HIStalk Practice Web page format and logo. We refreshed HIStalk Mobile (now known as HIStalk Connect) a couple of weeks ago and HIStalk’s transition is coming soon. A big thank you to the folks at Dodge Communications for the providing us with the snappy logo designs. We really hope you like the new look.

E-mail Inga.

Joel Diamond: The Year in Review

It’s that time of year. Every legitimate news outlet airs or publishes its “Top Stories of the Year” piece. Since I’ve yet to see a good one for healthcare IT, I thought that this would be the time to start a new tradition here at HIStalk. So without further ado, I bring you the six most compelling news events as related to our industry in 2012.

US Doctors Accept Payments to Use Electronic Records

In one of the top stories this year, a widespread bribery scandal continues to unfold. It is now evident that millions of dollars have been slipped into the pockets of soiled white coats, outdated sport jackets, and questionably needed scrubs throughout the nation. 

Investigators confirm that these payments were made to a group calling themselves the “Eligible Providers,” apparently putting the lives of patients lives at risk by coercing doctors to use computers in their practices. 

One of the ringleaders in the bribery scandal, Farzad “The Enforcer” Mostashari, was heard in a federal wiretap saying, “Yeah, this year they should accept our generous offer, if not they will be payin’ us… big time. After that, we start breakin’ kneecaps.”

Justice Department officials have estimated that upwards of 45 percent of US physicians have heroically rejected this extortion, but fear that those numbers may be dwindling.

Meaningful Use

In a shocking blow to physician autonomy, new draconian regulations threaten to bring an otherwise efficient healthcare system to its knees. One of the more controversial requirements includes forcing doctors to record rarely-used data such as patient vital signs, allergies, and medications.  An unnamed spokesperson for the AMA is quoted as saying, “This kind of needless oversight is unconscionable. What’s next? Making us keep a list of current medical problems?“  

Jack Meihoff, chairman of the Center to Promote Continued Medical Errors, says the legislation is illegal. He adds, “If the Founding Fathers intended doctors to e-prescribe, then why did they sign the Constitution with a feather pen?” 

It appears that the new rules don’t stop here. Rumors are spreading in Washington that new legislation might require providers to care for patients with chronic diseases using well-established guidelines.

ICD-10 Delayed

ICD-10 was endorsed by the Forty-Third World Health Assembly in May 1990 and came into use in WHO Member States in 1994. It is therefore not surprising that implementation has been further postponed to 2014. 

Using an odd analogy, Ben Dover, spokesman for the Central Association of Hospital Organizations Not Enough Standards (CAHONES), says, “After 22 years, it’s kinda like a 400-pound guy losing 30 pounds after getting a lap band. Who’s gonna notice?”

Elected Officials Agree — US Healthcare is Expensive, But You Get What You Pay For

The election year was marked by misstatements, exaggerations, and outright lies on both sides. But here’s one thing that Republicans and Democrats have no disagreement about. Our growing fiscal crises need not be concerned with healthcare because our system has its priorities in order. 

For instance, amongst OECD member countries, the US again ranks among the worst for strokes, heart attacks and infant mortality. But this year, it’s #1 in the number of MRI machines.

Black Friday Shopping Frenzy Leaves Dozens Dead

After sleeping out all night in the frigid Wisconsin air, hundreds of frenzied CIOs rushed the doors at the Madison EpicMart after Thanksgiving, hoping to be lucky enough land a new EHR this holiday season. Several people were trampled to death. 

“I don’t understand it,” said one shaken onlooker. “You can buy a system for millions of dollars cheaper. Why are these people doing this? I’m just trying to score a good deal on a flat screen.”

Meanwhile, Costco owners express satisfaction with the “steady but well-behaved shoppers” in the eClinicalWorks aisle.

ACOs Top CEO Wish Lists

A nationwide poll of top hospital executives shows ACOs edging out The Amazing Motorized Web Shooting Spider-Man Figure and the LEGO Hobbit Game as this season’s most sought-after gift. Retailers are bracing for heavy demand in the coming year as well. “We can’t seem to keep these ACOs on the shelf,” says one distributor. 

More concerning is that most new owners don’t realize the potential havoc their new purchase might cause once they get it home. A seasoned seller warns, “Don’t get any water on it, and never, never ever feed it after midnight.”

Industry insiders were stunned at the remarkable interest in ACOs. Many predicted that Big Data and the Furby would be the top sellers this year.

Seriously, I wish each and every one of you a very happy, peaceful, and most importantly healthy New Year.

Joel Diamond, MD is chief medical officer at dbMotion, adjunct associate professor at the Department of Biomedical Informatics at the University of Pittsburgh, and a practicing physician at UPMC and of the Handelsman Family Practice in Pittsburgh, PA.

News 12/13/12

ONC advises Eligible Professionals (EPs) participating in the Medicare or Medicare 2012 MU programs that  that they must have completed their 90- or 365-day reporting period by December 31 to receive an incentive payment. Medicare EPs must complete attestation for the 2012 program year by February 28, 2013, but have the option to attest as soon as their reporting period is complete.

Also from ONC: analysts massage CDC’s recently reported EHR adoption numbers and conclude that more office-based physicians are using EHRs that have higher-level functionality to meet MU objectives. ONC notes that e-prescribing rates have more than doubled since 2009 and that two-thirds of physicians now use computerized tools such as electronic medication lists and drug interaction checks. The bottom line: MU is spurring EHR adoption.

ABQ Health Partners, New Mexico’s largest independent physician group, notifies an unspecified number of patients of a potential data breach following the loss or theft of a doctor’s laptop.

A Health Affairs-published study finds that ER usage is significantly lower for patients who have access to after-hours services with their primary care provider. They also have a lower rate of unmet medical needs.

The Orange County Register names Kareo a “Top Workplace in Orange County.”

Researchers find that overweight and obese adults may lose more weight when using a smartphone to track diet and exercise. Patients using a mobile device to record exercise and food intake, along with occasional phone coaching, lost an average of eight pounds more than those not using mobile devices to track behavior.

University of Utah Health Care offers online access to its database of 40,000 patient satisfaction surveys, including comments about its 1,200 physicians.

CMS asks physicians to provide feedback about the collection and use of patient experience measurements for Physician Compare, the consumer website that tracks and reports physician performance data.

HHS launches an educational initiative that includes online tools to help providers protect patient health information on laptops and mobile devices. Resources include videos, FAQs, and downloadable materials on everything from device encryption, stolen devices, and EHR access on mobile devices.

I haven’t mentioned this in a while, but we always welcome Readers Write contributions. The general guidelines: articles of up to 500 words in length, subject to editing for clarity and brevity. We only run original articles that have not appeared elsewhere and we can’t use anything that looks like a commercial pitch. For HIStalk Practice, we would be especially welcoming of contributions of interest to those in the ambulatory practice world. Everyone has an opinion or two on the HIT world that they are dying to express and we would be happy to provide you the perfect forum to share your musings.

E-mail Inga.

News 12/11/12

About 66 percent of office-based physicians will apply or have applied for MU incentives, according to a CDC survey, though only 27 percent of those have EMRs that can support the Stage 1 objectives of the 15 total. The 27 percent number sounds low to me, so I am wondering if (a) some respondents weren’t sure about the capabilities and certification status of their EMR, and (b) since the survey was done between February and July 2012, some practices may have been on an older release. EMR use by office-based physicians jumped from 48 percent in 2009 to 72 percent in 2012, though only 40 percent report having a system that meets the criteria for a basic system.

The Healthcare Information Xchange of New York recognizes Lansingburgh Family Practice with the Game Changer Award in recognition of its HIE participation, as well as MEDENT for connecting more practices to HIXNY than all other EMR companies combined.

Websites with health-specific content or services for physicians, such as Medscape, reach the highest percentage of physicians (81 percent) compared to other types of health sites. Though only about four percent of physicians visit EHR portals, doctors spend an average of 18 minutes on those sites versus 5.1 minutes on professional health content sites. The same report finds that physicians still use computers for work more than any other type of device, though most would like to use mobile phones and tablets.

Epocrates releases a native app for the iPad and iPad Mini tablets.

Rite Aid pharmacies will send patient immunization records to healthcare providers using The Surescripts Network for Clinical Interoperability.

MacPractice releases the MacPractice Check in App for iPad, a HIPAA-compliant app to automate check-in procedures.

ONC updates its Health IT Dashboard to include summary data on the EHR incentive program. It’s not really new data, but the maps and graphs are interactive and fun to manipulate if you like that kind of stuff.

By the way, EPs have collected about $223 million in EHR incentives from Medicare and Medicaid through the end of November.

e-MDs and eClinicalWorks join Orion Health and ICA to fund the country’s first HIE laboratory at the University of Texas at Austin.

DrFirst announces Akario, a free secure clinical messaging system for providers.

KLAS says it will announce its top-ranked software and service vendors for 2012 on Friday, December 14.

E-mail Inga.